Provider Demographics
NPI:1396072476
Name:RUIZ, NANCY L (MA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5A18 CALLE FRANCISCO ZUNIGA
Mailing Address - Street 2:FAIRVIEW
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7708
Mailing Address - Country:US
Mailing Address - Phone:787-638-2151
Mailing Address - Fax:
Practice Address - Street 1:CARR 165
Practice Address - Street 2:CENTRO INTERNACIONAL DE MERCADEO, TORRE I, SUITE 401
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8047
Practice Address - Country:US
Practice Address - Phone:787-638-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2149103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist